Rehabilitation of a Child with Neonatal Brachial Plexus Palsy: Case Report Described by Parents

This paper presents a case report of a child with Neonatal Brachial Plexus Palsy on the right arm, with C5, C6, and C7 nerve injuries. The symptoms presented at birth and at the time of diagnosis were absence of movement in the right arm but with mobility of the fingers; internal rotation of the injured limb with elbow extension; active flexion of the wrist and fingers; and ulnar deviation of the hand. The rehabilitation plan followed the conservative approach and included different intervention strategies (passive and active mobilisation, kinesio tape, use of splints, bimanual stimulation, etc.) carried out by the occupational therapist and the physical therapist. The rehabilitation allowed the child to have a functional limb for daily activities, with bimanual motor integration and coordination; passive and active range of motion in the different joints except for pronation, sensibility, and maintained strength. In conclusion, it can be said that this case report describes a set of rehabilitation strategies that were used in the conservative treatment of a child with NBPP and the functional gains they allowed. Early intervention, parental involvement in the rehabilitation process, and continuous follow-up of the child favoured the prognosis and allowed the prevention of functional sequelae of the limb.info:eu-repo/semantics/publishedVersio

Rehabilitation of Neonatal Brachial Plexus Palsy: Integrative Literature Review

This integrative literature review has been carried out with the aim of analyzing the scientific literature aimed at identifying and describing existing rehabilitation treatments/therapies for neonatal brachial plexus palsy (NBPP). NBPP is a frequent consequence of difficult birthing, and it impairs the function of the brachial plexus in newborns. This is why knowledge on rehabilitation strategies deserves special attention. The data collection was carried out in January 2019, in the EBSCOhost and BVS (Biblioteca Virtual em Saúde) platforms, in the CINAHL Complete, MEDLINE Complete, LILACS and PubMed databases. Thirteen articles were included in this integrative literature review, based on a literature search spanning title, abstract and full text, and considering the inclusion criteria. Two main treatments/therapies for NBPP rehabilitation were identified: conservative treatment and surgical treatment. Conservative treatment includes teamwork done by physiatrists, physiotherapists and occupational therapists. These professionals use rehabilitation techniques and resources in a complementary way, such as electrostimulation, botulinum toxin injection, immobilizing splints, and constraint induced movement therapy of the non-injured limb. Professionals and family members work jointly. Surgical treatment includes primary surgeries, indicated for children who do not present any type of spontaneous rehabilitation in the first three months of life; and secondary surgeries, recommended in children who after primary surgery have some limitation of injured limb function, or in children who have had some spontaneous recovery, yet still have significant functional deficits. Treatment options for NBPP are defined by clinical evaluation/type of injury, but regardless of the type of injury, it is unanimous that conservative treatment is always started as early as possible. It should be noted that there was no evidence in the literature of other types of rehabilitation and techniques used in clinical practice, such as preventive positioning of contractures and deformities, hydrotherapy/aquatic therapy, among others, so we consider there is a need for further studies at this level in this area.info:eu-repo/semantics/publishedVersio

Permutability in proof terms for intuitionistic sequent calculus with cuts

This paper gives a comprehensive and coherent view on permutability in the intuitionistic sequent calculus with cuts. Specifically we show that, once permutability is packaged into appropriate global reduction procedures, it organizes the internal structure of the system and determines fragments with computational interest, both for the computation-as-proof-normalization and the computation-as-proof-search paradigms. The vehicle of the study is a lambda-calculus of multiary proof terms with generalized application, previously developed by the authors (the paper argues this system represents the simplest fragment of ordinary sequent calculus that does not fall into mere natural deduction). We start by adapting to our setting the concept of normal proof, developed by Mints, Dyckhoff, and Pinto, and by defining natural proofs, so that a proof is normal iff it is natural and cut-free. Natural proofs form a subsystem with a transparent Curry-Howard interpretation (a kind of formal vector notation for lambda-terms with vectors consisting of lists of lists of arguments), while searching for normal proofs corresponds to a slight relaxation of focusing (in the sense of LJT). Next, we define a process of permutative conversion to natural form, and show that its combination with cut elimination gives a concept of normalization for the sequent calculus. We derive a systematic picture of the full system comprehending a rich set of reduction procedures (cut elimination, flattening, permutative conversion, normalization, focalization), organizing the relevant subsystems and the important subclasses of cut-free, normal, and focused proofs.Partially financed by FCT through project UID/MAT/00013/2013, and by COST action CA15123 EUTYPES. The first and the last authors were partially financed by Fundação para a Ciência e a Tecnologia (FCT) through project UID/MAT/00013/2013. The first author got financial support by the COST action CA15123 EUTYPES.info:eu-repo/semantics/publishedVersio

Integración de la familia en los cuidados de enfermería: perspectiva de los enfermeros y los estudiantes de enfermería

Enquadramento: A pertinência da integração das famílias nos cuidados de enfermagem permite a promoção, manutenção e recuperação da saúde das famílias. Objetivos: Identificar e descrever a perspetiva dos enfermeiros e estudantes de enfermagem sobre a integração das famílias nos cuidados de enfermagem. Metodologia: Estudo inferencial, transversal, numa população de enfermeiros e estudantes de en fermagem. Foi aplicada a escala Families Importance in Nursing Care – Nurses Attitudes (FINC-NA). Resultados: Amostra constituída por 164 indivíduos, nos quais 71 eram profissionais e 93 estudantes. A média da importância atribuída à família foi maior nos estudantes de enfermagem relativamente aos enfermeiros, sendo a diferença entre os dois grupos significativa. Na análise de regressão linear univariada as variáveis: Idade, Anos de experiência profissional e Formação na área da família parecem estar associadas à importância atribuída à família. Conclusão: Os estudantes atribuem maior importância à integração da família do que os enfermeiros. As variáveis Idade, Anos de exercício profissional e Formação na área da família, nos enfermeiros, associam-se a uma maior importância da integração da família.info:eu-repo/semantics/publishedVersio

Cardiac Doppler Variation with Volume Status Changes in General Intensive Care

Num grupo de 64 doentes de uma Unidade de Cuidados Intensivos, 24 dos quais submetidos a ventilação mecânica, foi determinada a influência da modificação da volémia nas características do Doppler cardíaco, através da negativização do balanço hídrico e correspondente modificação da pressão venosa central. Com a modificação da volémia, a relação E/A do fluxo transvalvular mitral mostrou uma tendência para reduzir, o tempo de desaceleração da onda E mitral para diminuir, o tempo de relaxamento isovolumétrico para aumentar, e a veia cava inferior reduziu o seu diâmetro expiratório e aumentou o valor do colapso inspiratório. Não se observou uma correlação significativa entre os valores das variáveis estudadas e a modificação da volémia, inclusivamente entre a pressão venosa central e o balanço hídrico. A modificação da volémia em doentes críticos modifica as características de determinados parâmetros de ecocardiografia- -Doppler, mas não é possível predizer a magnitude dessa variação

Type-based termination of recursive definitions

This paper introduces "lambda-hat", a simply typed lambda calculus supporting inductive types and recursive function definitions with termination ensured by types. The system is shown to enjoy subject reduction, strong normalisation of typable terms and to be stronger than a related system "lambda-G" in which termination is ensured by a syntactic guard condition. The system can, at will, be extended to also support coinductive types and corecursive function definitions.Information Society Technologies (IST) - Fifth Framework Programm (FP5) - TYPES.Fundação para a Ciência e a Tecnologia (FCT) – PRAXIS XXI/C/EEI/14172/98.INRIA-ICCTI.Estonian Science Foundation (ETF) - grant no. 4155

Pre-training autoencoder for lung nodule malignancy assessment using CT images

Lung cancer late diagnosis has a large impact on the mortality rate numbers, leading to a very low five-year survival rate of 5%. This issue emphasises the importance of developing systems to support a diagnostic at earlier stages. Clinicians use Computed Tomography (CT) scans to assess the nodules and the likelihood of malignancy. Automatic solutions can help to make a faster and more accurate diagnosis, which is crucial for the early detection of lung cancer. Convolutional neural networks (CNN) based approaches have shown to provide a reliable feature extraction ability to detect the malignancy risk associated with pulmonary nodules. This type of approach requires a massive amount of data to model training, which usually represents a limitation in the biomedical field due to medical data privacy and security issues. Transfer learning (TL) methods have been widely explored in medical imaging applications, offering a solution to overcome problems related to the lack of training data publicly available. For the clinical annotations experts with a deep understanding of the complex physiological phenomena represented in the data are required, which represents a huge investment. In this direction, this work explored a TL method based on unsupervised learning achieved when training a Convolutional Autoencoder (CAE) using images in the same domain. For this, lung nodules from the Lung Image Database Consortium and Image Database Resource Initiative (LIDC-IDRI) were extracted and used to train a CAE. Then, the encoder part was transferred, and the malignancy risk was assessed in a binary classification—benign and malignant lung nodules, achieving an Area Under the Curve (AUC) value of 0.936. To evaluate the reliability of this TL approach, the same architecture was trained from scratch and achieved an AUC value of 0.928. The results reported in this comparison suggested that the feature learning achieved when reconstructing the input with an encoder-decoder based architecture can be considered an useful knowledge that might allow overcoming labelling constraints.This work is financed by National Funds through the Portuguese funding agency, FCT—Fundação para a Ciência e a Tecnologia within project UIDB/50014/2020

Biossolubilização de fonolito por microrganismos do solo solubilizadores de potássio.

A produção nacional de fertilizantes potássicos atende somente 10% da demanda do agronegócio brasileiro. Como os solos brasileiros, em geral, possuem baixa fertilidade, verifica-se a necessidade de pesquisas visando novas fontes deste nutriente para a produção agrícola. Neste estudo, procurou-se avaliar o potencial de diferentes estirpes de microrganismos pertencentes à coleção de Microrganismos Multifuncionais da Embrapa Milho e Sorgo quanto à biossolubilização de potássio a partir da rocha fonolito in vitro. Testaram-se 13 isolados, sendo três bactérias e dez fungos quanto à taxa de solubilização em meio de cultura líquido, após 10 dias de agitação, sob temperatura de 28°C. Os teores de potássio foram determinados nos sobrenadantes das culturas enriquecidas após a filtração. Os resultados mostraram que a biodisponibilidade de potássio nos meios de cultura variaram significativamente em função dos isolados. A bactéria B30 foi a estirpe mais eficiente na solubilização de K, com incremento de 70% de solubilização, em relação ao controle não inoculado. Observou-se uma correlação negativa entre os valores do pH no meio de cultura e taxa de solubilização das estirpes. Estes resultados sugerem que os microrganismos avaliados podem ser utilizados para otimizar a biodisponibilidade de potássio a partir de rochas silicáticas